The Lived Experience of Family Nurse Practitioners Performing Sexual Health Assessments PDF
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CCiittyy UUnniivveerrssiittyy ooff NNeeww YYoorrkk ((CCUUNNYY)) CCUUNNYY AAccaaddeemmiicc WWoorrkkss Dissertations, Theses, and Capstone Projects CUNY Graduate Center 5-2015 TThhee LLiivveedd EExxppeerriieennccee ooff FFaammiillyy NNuurrssee PPrraaccttiittiioonneerrss PPeerrffoorrmmiinngg SSeexxuuaall HHeeaalltthh AAsssseessssmmeennttss Madeleine Mary Lloyd Graduate Center, City University of New York How does access to this work benefit you? Let us know! More information about this work at: https://academicworks.cuny.edu/gc_etds/1025 Discover additional works at: https://academicworks.cuny.edu This work is made publicly available by the City University of New York (CUNY). Contact: [email protected] THE LIVED EXPERIENCE OF FAMILY NURSE PRACTITIONERS PERFORMING SEXUAL HEALTH ASSESSMENTS by MADELEINE M. LLOYD A dissertation submitted to the Graduate Faculty in Nursing in partial fulfillment of the requirements for the degree of Doctor of Philosophy, The City University of New York. 2015 © 2015 Madeleine M. Lloyd All Rights Reserved ii This manuscript has been read and accepted for the Graduate Faculty in Nursing in satisfaction of the dissertation requirement for the degree of Doctor of Philosophy. Dr. Keville Frederickson Date Chair of Examining Committee Dr. Donna Nickitas Date Executive Officer Dr. Martha V. Whetsell Dr. Jamesetta A. Newland Dr. Brigitte S. Cypress Dr. Deborah L. Tolman Supervisory Committee THE CITY UNIVERSITY OF NEW YORK iii Abstract THE LIVED EXPERIENCE OF FAMILY NURSE PRACTITIONERS PERFORMING SEXUAL HEALTH ASSESSMENTS by Madeleine L. Lloyd Adviser: Professor Keville Frederickson Sexuality incorporates a multitude of feelings including beliefs, fantasies, and aspects of pleasure, intimacy, and reproduction. In addition, sexuality involves rights to gender identity and role, sexual acts and orientation. Sexual and reproductive health and rights is a global health, development, and human rights priority. Universal access to sexual and reproductive health is essential. Negative sexual health outcomes are increasing in the United States and sexuality is often a neglected area for health providers including nurses. With an increasing share of the primary care services nationally, family nurse practitioners (FNPs) have the means to provide quality sexual health care across the life span and improve universal access and sexual health outcomes. The purpose of this qualitative study was to understand the lived experiences of female FNPs when performing sexual health assessments on their adult clients in primary care. Family nurse practitioners are educated and trained to provide holistic, client centered nursing care inclusive of sexual health assessments. The study included in-depth interviews with ten female FNPs. These interviews were analyzed using van Manen’s interpretive phenomenological approach. The Self-Concept Mode of The Roy Adaptation Model guided this study. Understanding the phenomenon of the lived experience of female FNPs illuminated the common experiences and shared meanings for FNPs. The interpretive statement was: The performance of iv a sexual health assessment by FNPs on their adult clients in primary care is the development of presence and prudence in relation to their level of their self-concept. Since sexual health affects all human beings, there are global nursing implications for education, practice, and research in understanding the meanings of the essential themes of presence, prudence, and self-concept. v Acknowledgments This journey would not have been possible without a village of people who supported me, cared for me, and encouraged me to continue this process until the end. It is impossible to thank my entire village of people but I would like to acknowledge the following. Firstly my committee members; Dr. Keville Frederickson, my chair, my advocate, and my cheerleader. Thank you for your support and laughter over the past six years. Dr. Martha Whetsell, thank you for the endless loving kindness you have shown to me throughout this experience. Your input and support have changed my worldview for the better. Dr. Jamesetta Newland, thank you for extending yourself to add another commitment to all of your ongoing and important projects, for listening closely, and for always being available. Dr. Brigitte Cypress, thank you for your expertise in qualitative methodology. Dr. Deborah Tolman, thank you for your inspiration and for providing me with another worldview outside of nursing. To The Graduate Center Nursing Science Executive Officer, Dr. Donna Nickitas, thank you for the words of encouragement, energy, and for being a helpful and fearless leader. To Dr. Miguel Villegas-Pantoja, visiting assistant professor, thank you for your gentle encouragement, and technical expertise. It has been a pleasure getting to know you. I do not know what I would have done without Ana Mola, my friend, and doctoral sister, thank you for your integrity, wit, and wisdom. You were a constant source of relief and you patched me together, intellectually and emotionally. Thank you Lina Courtadiou for caring for my children in the middle of the night so that I could keep writing and for allowing me the time to borrow your partner. For the past six years, I have been a part of an incredible group of women known as Cohort 4. What a strong group of women whose friendship, insight, and encouragement vi supported me through this journey. Ana, Barbara, Catherine, Darcel, Kathy, Meriam, Michele, Monique, and Regina I appreciate all of your feedback and reassurance over the years. I feel blessed to have been a part of this Cohort. To my professors, Dr. Eleanor Campbell, Dr. Barbara DiCicco-Bloom, Dr. Alicia Georges, Dr. Eileen Gigliotti, Dr. Marianne Jeffreys, Dr. Margaret Lunney, Dr. Violet Malinski, Dr. Kathleen Nokes, Dr. Carol Roye, and Dr. Vidette Todaro-Franceschi, thank you for sharing your nursing knowledge and for supporting me through this process. To my friends, mentors, and colleagues at New York University College of Nursing and College of Dentistry, thank you for your patience, compassion, and kindness. Special thanks to Dr. Judith Haber, Dr. Terry Fulmer, Dr. Daniel Malamud, and Dr. Carla Mariano for your leadership, mentoring, and numerous words of wisdom. To Dr. Edwidge Thomas, Barbara Donofrio, Dr. Leslie Taub, and my administrative staff at NFP for your support, caring, and patience. To the ten FNP participants who gave so selflessly their limited free time. They have contributed towards improving nursing science, education, and practice by sharing their lived experiences with me so that this work could come to life. Most of all, it is with the utmost gratitude that I thank my parents, the late Michael Lloyd and Patricia Lloyd for making it possible for me to have a scientific curiosity, for their constant support, love, and guidance. It was they who first instilled a sense of determination, a desire to achieve my potentials, and a passion for learning. To my sister, Annabel, for her words of encouragement, love, and support from across the ocean. To my children Sophia and Michael who have never known a mother without doctorate school in her life. You are my sources of inspiration, love, and joy. Finally, I am faced with the vii impossible task of thanking my husband, Hiran Cantu. You gave me time and space literally and figuratively, to help me through this. Thank you and your family. I love you, your mind, and wisdom. Madeleine (Mimi) viii Dedication This study is dedicated to the memory of my grandparents, Reginald and Eve Brown (Popa and Nana) who provided me with a delightful childhood environment to learn, play, and read. It was through their fun play, Big Bun, and a lovingly home cooked meal that I was able to achieve entry into SACAE in Adelaide, Australia. The beginning of it all. I am eternally grateful. What wonderful role models and cherished memories. ix
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